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Individual

MR. ERNESTO T PADRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
509 MEADOWLARK LANE, CRANE, MO 65633
(417) 723-5281
Mailing address
4141 W SANDY ST, BATTLEFIELD, MO 65619-9840
(417) 889-6717

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2000166694
MO

Other

Enumeration date
08/21/2008
Last updated
08/21/2008
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